Provider Demographics
NPI:1154767283
Name:KANDA, LAUREN (MA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KANDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24485 SE 179TH ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-7343
Mailing Address - Country:US
Mailing Address - Phone:206-406-9414
Mailing Address - Fax:
Practice Address - Street 1:24485 SE 179TH ST
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-7343
Practice Address - Country:US
Practice Address - Phone:206-406-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist